Provider Demographics
NPI:1679323752
Name:CHICAGO COUNSELING CAFE PLLC
Entity Type:Organization
Organization Name:CHICAGO COUNSELING CAFE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-890-1408
Mailing Address - Street 1:3654 S HERMITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1219
Mailing Address - Country:US
Mailing Address - Phone:847-890-1408
Mailing Address - Fax:
Practice Address - Street 1:3654 S HERMITAGE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1219
Practice Address - Country:US
Practice Address - Phone:847-890-1408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty